Consumer-Directed Plans See Bump in Enrollment

The number of companies that offer a consumer-directed health plan (CDHP) to their employees is steadily, albeit slowly, increasing. Nearly half of large employers say they have offered a CDHP to their employees, and the number of employees

enrolled in the programs has nearly doubled over the last two years, according to results of a survey by Watson Wyatt and the National Business Group on Health. Findings from similar surveys by the Center for Studying Health System Change and the Commonwealth Fund seem to echo these findings.

National surveys suggest that while CDHPs — typically high-deductible health plans accompanied by either a health reimbursement arrangement (HRA) or health savings account (HSA) — are being offered by a growing number of employers, enrollment in these products constituted just 5 percent of total enrollment in employer-sponsored health plans in 2007, according to the center.

In the Watson Wyatt/National Business Group on Health survey, of the 453 large employers who participated, 47 percent currently offer a CDHP; that’s up from 39 percent in 2007 and 33 percent in 2006. By 2009, 54 percent of companies plan to offer a CDHP.

With more employers offering this type of health plan, the number of employees who enroll rises as well. According to the survey, CDHP enrollment is about 15 percent in companies that offer it, up from 10 percent in 2007 and 8 percent in 2006. Only 6 percent of companies report 100 percent enrollment in a CDHP, but that number is projected to rise to 9 percent in 2009.

But does enrolling in a CDHP really save money? Of those companies with at least half of their workforce enrolled in a CDHP, the two-year median medical and pharmacy cost increase was about 3.6 percent. That’s about half of the increase for companies with no CDHP offering.

Overall, companies with a CDHP experienced a two-year cost increase of 5.5 percent, versus 7 percent without a CDHP.

“As popularity of the consumer-driven approach grows, companies will be able to better manage costs and workers will take a more active interest in their own health care,” says Helen Darling, president of the National Business Group on Health. “Actively involving more workers in their health care and giving them the resources to make educated decisions can be a challenge, but it should be embraced. The end result can be a mutually beneficial system for both companies and their workers.”